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The Day of Your Craniotomy

Arrive at the hospital on time. You may still have concerns and are likely to feel a bit nervous. Your health care team will try to answer all your questions. They will also do all they can to put you at ease.

Just Before Surgery

Side view of head with skull inside. Four small holes are in skull at corners of rectangle. Bone inside rectangle is removed.

The health care provider in charge of your anesthesia will talk with you before surgery. You will be given general anesthesia to help you “sleep” through the surgery. At some point, an IV (intravenous) line is placed in your arm. This line can supply medication and fluids as needed. In many cases, some or all of your hair is trimmed or removed. This is done to decrease the risk of infection.

Reaching the Brain

The surgeon makes an incision in your scalp. Then dime-sized burr holes are drilled in the skull. The bone between the holes is cut and lifted away. The surgeon then opens the dura, exposing the brain. The next step will depend on your specific problem. In some cases, certain nerves may be stimulated while the response in the brain is monitored. This is done to make sure that normal brain tissue is not disturbed during the surgery.

Finishing the Craniotomy

When the goal of surgery is met, the dura covering the brain is closed. Usually, the skull bone is put back and held in place with wire mesh or screw plates. On occasion, an artificial mesh is used if the bone cannot be used again or if there is a bone infection (known as osteomyelitis). If blood or fluid remains in the brain tissue, a drain may be placed through a burr hole for a few days. Most of the time, the burr holes are filled or covered right after surgery. Then the skin incision is closed with stitches or staples.

Risks of Surgery

Risks of a craniotomy are:

  • Seizure (jerking movements or loss of consciousness) 

  • Infection

  • Loss of memory or confusion

  • Swelling or bleeding in the brain

  • Blood clots

  • Loss of sensation, including vision

  • Weakness or paralysis

  • Death

Note to Family and Friends

You can wait in a nearby room during surgery. Craniotomy often takes 3 to 5 hours, or more, to complete. If possible, be sure one person is always in the waiting room to receive any news. The doctor will come talk with you as soon as surgery is over. You’ll also be told when you can visit your loved one.

 

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